Men just as likely to suffer from postnatal depression

Kathy Evans

As a new father, Kham Sirimanotham's sense of duty towards his young family was paramount. His wife had been diagnosed with postnatal depression, so he was the one who did the shopping, made decisions and cuddled the baby when his wife was too listless to care.

With little family support, he juggled the intense needs of his wife and baby with his job as a civil servant. As the milestones passed and his daughter grew into a toddler, he found it increasingly hard to cope. Anxiety gnawed at his stomach, he lost weight and became inert: ‘‘In my darkest days all I could think of was going to sleep and hoping it would go away. But then I couldn’t sleep.’’

Finally it clicked that he too was suffering postnatal depression. Two years after his daughter was born, he visited the GP and was given antidepressants.

After a few weeks on medication he was feeling worse. Trying to manage the raw needs of his daughter, along with the constant worry he felt towards his wife, left him feeling hollowed out. As his symptoms worsened, his GP referred him to a psychiatric ward, where he spent three weeks learning to listen to what his body was trying to tell him.

Sirimanotham's experience is not unique. Men are just as likely to suffer from postnatal depression following the birth of a baby as women, research shows.

While one in 10 mothers suffer from postnatal depression, an Australian study, published in the Journal of Social Psychiatry and Psychiatric Epidemiology shows that men are equally prone to the illness in the first year of the baby’s life.

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But because postnatal depression is traditionally associated with womanhood, it is not picked up, or taken seriously, in men.

The study also shows that 30 per cent of fathers who have problems in the first year of their child’s life continue to report ongoing mental health issues.

According to Professor Philip Boyce, head of the Perinatal Psychiatry Clinical Research Unit at Sydney’s Westmead Hospital, fathers under the age of 30, and men who have suffered previous bouts of depression are also at a higher risk.

“I don’t think people have recognised that men get depressed at this time,” says Professor Boyce. “It is one of the things we should be looking for when we see women with postnatal depression.”

While postnatal depression in men obviously doesn’t contain a hormonal component, the same stresses that can trigger it in women such as fatigue, isolation and poor social networks, can also affect men.

Traditionally, men have dealt with stress by drinking too much, working too hard and using a variety of other behaviours such as gambling, as a means of alleviating their distress rather than talking about how they feel: “But that maybe changing as we encourage men to talk about their feelings,” Professor Boyce said.

These days, organisations such as PANDA, beyondblue and the Melbourne charity Centre of Perinatal Excellence (COPE) promote awareness of postnatal depression in men. But more needs to be done, experts said.

Professor Boyce says employers need to cut new dads more slack, while Dr Nicole Highet, founder of COPE, has called for extending the screening of pregnant women for PND to include their partners, “given that we know that the husbands of [affected women] are 50 per cent more likely to develop it.”

Dr Highet said the latest data showed depression in new fathers could also have a negative impact on the child. “The quality of the interaction is different when the father is depressed. We don’t fully understand the mechanisms yet but we think the child’s development may be slowed down and they may be more prone to emotional problems, so it’s important for men to identify and get treatment for depression. Fathers are important.”

According to Howard Todd-Collins, psychotherapist and director of Melbourne-based Men and Relationships Counselling: ‘‘What I would see as depression, some guys would talk about in terms of feeling out of control, being more agitated, or angry. Or they may say they feel lost and want to hide or withdraw.’’

For Todd-Collins, depression in new fathers is often triggered by being emotionally unprepared. In the months before birth, the imagined baby reigns supreme – prospective parents are encouraged to stroke it, sing to it, play Mozart and avoid smoky atmospheres.

Bookshelves groan under the weight of pregnancy manuals; catalogues and shop windows pander to parental fantasies with frilly bassinets and ergonomically designed prams. Then the baby is born, its perfection suddenly tainted. An eerie silence descends when it comes to discussing the inevitable insurrection of identity that has taken place in the homes of newborns everywhere.

Says Todd-Collins: ‘‘A lot of the work I do with men is around emotional awareness that comes with things such as loss of freedom, lack of sleep, sex and so on ... all the things they took for granted before. Some dads just aren’t prepared and it becomes very difficult.’’

The internet is a good place to find help initially, says Boyce, with websites such as MoodGYM offering first-line treatment and strategies. ‘‘A very small minority of men may need some medication; the majority would benefit from counselling or cognitive therapy.’’

These days Kham Sirimanotham is in a good place. ‘‘I eat well, I stay in routines. I do meditation. If I ever feel sad or depressed I take it seriously. It’s hard for guys because there is still a stigma around mental health and you worry about being seen as weak. But I don’t care what other people think. I’m proud to say I had it, I got help and I’ve recovered. It feels like a real achievement.’’

Says Todd-Collins: ‘‘The striking thing for me is how many men are willing to talk about it. Once they begin to speak about their feelings and know they are not going to be judged, but supported, I think they see it as a big relief.’’